<style type="text/css">
.abc123 label{

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td > strong{

}
</style>
<div align="left" class="abc123">
		  <table width="100%" border="0">
			<tbody><tr>
				<td width="20%"><strong>Nomor Surat</strong></td>
				<td width="80%"><i id="tpl_no_surat"></i>
</td>
			</tr>
			<tr>
				<td><strong>Tanggal</strong></td>
				<td><i id="tpl_tgl_surat" size="10"></i>
</td>
			</tr>
						  <tr>
				  <td><strong>Cabang Afiliasi</strong></td>
				  <td>
					<i id="tpl_id_afiliasi"></i>
				  </td>
			  </tr>
			  			
				<tr>
					  <td><strong>Nama Perusahaan</strong></td>
					  <td>
					  <i id="tpl_Importir"></i>
					  </td>
				  </tr>
					<tr>
					  <td><strong>Alamat</strong></td>
					  <td><i id="tpl_Alamat_Importir"></i>
</td>
				  </tr>
				  <tr>
					  <td><strong>Fax </strong></td>
					  <td><i id="tpl_Fax_Importir"></i>
</td>
				  </tr>
			<tr>
				<td><strong>Attn</strong></td>
				<td><i id="tpl_ql_attn" ></i>
</td>
			</tr>
			<tr>
				<td><strong>Kepada (nama)</strong></td>
				<td><i id="tpl_ql_dear" ></i>
</td>
			</tr>
			<tr>
				<td valign="top"><label for="ql_subject"><strong>Subject</strong></label></td>
				<td valign="top">
					<i id="tpl_ql_subject" ></i>
					<br style="display:block;margin-bottom:4px"/>
					<label for="ql_no"><strong>No</strong></label> <i id="tpl_ql_no"></i>
&nbsp;&nbsp;
					<label for="ql_date"><strong>Tanggal</strong></label> <i id="tpl_ql_date"></i>
				</td>
			</tr>
			
			<tr><td style="border-top:1px dotted #333" colspan="2">&nbsp;</td></tr>
			
			<tr>
				<td valign="top" colspan="2"><strong>Scope of Work</strong></td>
			</tr>
			<tr>
				<td colspan="2">
					<div id="qlScopeOfWork"></div>
				<!-- 	<table><tbody><tr><td><input type="checkbox" value="1" id="chkSOW_1" name="chkSOW[]"></td><td><label for="chkSOW_1">Verification of Document</label></td></tr><tr><td><input type="checkbox" value="2" id="chkSOW_2" name="chkSOW[]"></td><td><label for="chkSOW_2">Identification and specification of goods</label></td></tr><tr><td><input type="checkbox" value="3" id="chkSOW_3" name="chkSOW[]"></td><td><label for="chkSOW_3">HS Classification</label></td></tr><tr><td><input type="checkbox" value="4" id="chkSOW_4" name="chkSOW[]"></td><td><label for="chkSOW_4">Visual Inspection (no running test performed)</label></td></tr><tr><td><input type="checkbox" value="5" id="chkSOW_5" name="chkSOW[]"></td><td><label for="chkSOW_5">Issue Certificate of Inspection (COI), if the goods are inspected in accordance with the Decree Ministry of Trade</label></td></tr><tr><td><input type="checkbox" value="6" id="chkSOW_6" name="chkSOW[]"></td><td><label for="chkSOW_6">Issue Report of Inspection (ROI), if the inspected goods not comply with the Decree Ministry of Trade</label></td></tr></tbody></table>					<br>
				 --></td>
			</tr>
			
			<tr>
				<td valign="top" colspan="2"><strong>Supported Document Needed for COI</strong></td>
			</tr>
			<tr>
				<td colspan="2">
					<div id="qlSupportedDoc"></div>
				<!-- 	<table><tbody><tr><td><input type="checkbox" value="7" id="chkCOI_7" name="chkCOI[]"></td><td><label for="chkCOI_7">Copy of Import Permit</label></td></tr><tr><td><input type="checkbox" value="8" id="chkCOI_8" name="chkCOI[]"></td><td><label for="chkCOI_8">Copy of Invoice</label></td></tr><tr><td><input type="checkbox" value="9" id="chkCOI_9" name="chkCOI[]"></td><td><label for="chkCOI_9">Copy of Packing List</label></td></tr><tr><td><input type="checkbox" value="10" id="chkCOI_10" name="chkCOI[]"></td><td><label for="chkCOI_10">Copy of Bill of Lading/ Airway Bill</label></td></tr><tr><td><input type="checkbox" value="11" id="chkCOI_11" name="chkCOI[]"></td><td><label for="chkCOI_11">Copy of NPWP, API and NIK</label></td></tr></tbody></table>				
 -->
				</td>
			</tr>
			
			<tr><td style="border-top:1px dotted #333" colspan="2"></td></tr>
			
			<tr>
				  <td><strong>Tanggal Pemeriksaan </strong></td>
				  <td><i id="tpl_Tanggal_Periksa" ></i>
</td>
			</tr>
			<tr>
				<td><strong>Tempat Pemeriksaan </strong></td>
				<td><i id="tpl_Alamat_Pemeriksaan"></i>
</td>
			</tr>
			<tr>
				<td width="20%"><strong>Inspection Fee</strong></td>
				<td width="80%">
				<i id="tpl_ql_price_curr"></i>
				<i id="tpl_ql_price"></i>
				</td>
			</tr>
			<tr>
				<td><strong>VAT (10%)</strong></td>
				<td><i id="tpl_ql_vat" ></i>
</td>
			</tr>
			<tr>
				<td><strong>Total</strong></td>
				<td><i id="tpl_ql_total"></i>
</td>
			</tr>
			<tr>
				<td><strong>Charge</strong></td>
				<td>
				<i id="tpl_ql_charge_curr"> 
</i>
				<i id="tpl_ql_charge"></i>
				</td>
			</tr>
			
			<tr><td colspan="2"></td></tr>
			<tr>
				<td style="border-bottom:1px dotted #333">&nbsp;</td>
				<td style="border-bottom:1px dotted #333"><strong>Bank Rupiah</strong></td>
			</tr>
			<tr>
				<td><label for="idr_bank">Nama Bank</label></td>
				<td><i id="tpl_idr_bank"></i>
</td>
			</tr>
			<tr>
				<td><label for="idr_bank_addr">Alamat</label></td>
				<td><i id="tpl_idr_bank_addr"></i>
</td>
			</tr>
			<tr>
				<td><label for="idr_bank_ac">No Rekening</label></td>
				<td><i id="tpl_idr_bank_ac"></i>
</td>
			</tr>
			<tr>
				<td style="border-bottom:1px dotted #333">&nbsp;</td>
				<td style="border-bottom:1px dotted #333"><strong>Bank USD</strong></td>
			</tr>
			<tr>
				<td><label for="usd_bank">Nama Bank</label></td>
				<td><i id="tpl_usd_bank"></i>
</td>
			</tr>
			<tr>
				<td><label for="usd_bank_addr">Alamat</label></td>
				<td><i id="tpl_usd_bank_addr" ></i>
</td>
			</tr>
			<tr>
				<td><label for="usd_bank_ac">No Rekening</label></td>
				<td><i id="tpl_usd_bank_ac" ></i>
</td>
			</tr>
			
			<tr>
				<td style="border-bottom:1px dotted #333">&nbsp;</td>
				<td style="border-bottom:1px dotted #333"><strong>From</strong></td>
			</tr>
			<tr>
				<td><label for="from_name">Nama Perusahaan</label></td>
				<td><i id="tpl_from_name" ></i>
</td>
			</tr>
			<tr>
				<td><label for="from_fax">Fax</label></td>
				<td><i id="tpl_from_fax" ></i>
</td>
			</tr>
			<tr>
				<td><label for="from_email">Email</label></td>
				<td><i id="tpl_from_email" ></i>
</td>
			</tr>
			
			<tr><td style="border-top:1px dotted #333" colspan="2"></td></tr>
			
			<tr>
				<td><strong>Nama Pejabat</strong></td>
				<td><i id="tpl_ql_tertanda" ></i>
</td>
			</tr>
			<tr>
				<td><label for="ql_jabatan">Jabatan</label></td>
				<td><i id="tpl_ql_jabatan"  ></i>
</td>
			</tr>
			<tr>
				<td><label for="ql_jab_init1">Inisial</label></td>
				<td>
					<i id="tpl_ql_jab_init1" ></i>
 /
					<i id="tpl_ql_jab_init2" ></i>
				</td>
			</tr>
			
		  </tbody></table>
		  </div>
<input type="hidden" id="">